[ad_1]
Since the start of the covid-19 pandemic, 420 babies have died from the new coronavirus in Brazil, a figure approximately ten times higher than that of the United States, the country with the highest number of deaths from the disease, according to official data. .
According to the US CDC (Centers for Disease Control and Prevention), 45 babies or children under one year of age lost their lives after being infected by the virus.
Among children aged one to five, the discrepancy between the two countries is also clear: there were 207 deaths from covid-19 in Brazil against 52 in the United States.
The Brazilian figures are also higher than those of the United Kingdom, which recorded only two coronavirus deaths among babies (less than a year). And more than in Mexico, where 307 children between zero and four years old died. France, for its part, had only four deaths between zero and 14 years due to the new coronavirus.
At the same time, the United States currently has the highest number of deaths from covid-19: 529,000, followed by Brazil (270,600) and Mexico (191,800), according to data from Johns Hopkins University.
The North American mortality rate from the virus (161.28 per 100,000 inhabitants) is also higher than that of Brazil (128.12 per 100,000 inhabitants).
Therefore, since the beginning of the pandemic, the covid-19 has killed proportionally more there than here.
Infant birth rates are also important data in this equation. The two countries have practically equal birth rates, according to the World Bank: 1.77 children per woman in the United States and 1.74 children per woman in Brazil.
In 2019, 3.5 million births were registered in the United States and 2.9 million in Brazil. The US population is 328.2 million and the Brazilian, 210 million.
In summary: Brazil has a higher number of deaths of infants and young children from covid-19, despite having fewer births than the United States, where, in turn, more people die from the virus, both in relative absolute numbers.
But, after all, what is behind this high number of deaths among infants and young children in Brazil?
Reasons
In addition to deaths, on the same basis of comparison with other nations, Brazil also has a significant number of children hospitalized for covid-19. This year alone, according to the latest epidemiological bulletin from the Ministry of Health, 617 babies (under one year old), 591 children from one to five years old and 849 children from six to 19 years old were hospitalized due to the disease.
According to experts heard by BBC News Brazil, there is no single answer to the problem.
The uncontrolled pandemic and the lack of an adequate diagnosis, combined mainly with comorbidities (associated diseases) and socioeconomic vulnerabilities, including the appearance of a syndrome associated with covid-19 in children, help to explain the tragic situation in Brazil.
But there is a caveat: although deaths are more numerous in Brazil compared to other countries in the world, it is important to remember that the risk of death in this age group is still “very low”, the scientists recall.
In fact, 420 babies represent only 0.15% of the total deaths from covid-19 in Brazil (270.6 thousand).
So the likelihood of a baby (or child) developing severe COVID-19 symptoms and dying from the disease is rare, but “not zero,” says Fatima Marinho, epidemiologist and senior consultant at Vital Strategies of BBC News Brazil.
“Deaths in this age group are rare, but it is necessary to end this myth that children do not die from covid-19,” he says.
Marinho emphasizes that deaths from covid-19 among babies and children in Brazil may be even higher if we take into account deaths from unspecified SARS (severe acute respiratory syndrome).
“We can say that 48% of those who died from SARS not specified have a high probability of death from covid-19 due to clinical and epidemiological criteria,” he says.
According to Marinho, preliminary data from a survey conducted by Vital Strategies and UFMG (Federal University of Minas Gerais), in three capitals, showed that 90% of unspecified SARS cases proved to be covid-19, after the investigation.
She points out that covid-19 tends to evolve differently in children and adults.
As young children are not normally tested for coronavirus, since, in practice, they are much less susceptible to developing the most severe symptoms of the disease (and many are asymptomatic), their symptoms can easily be confused with those of others diseases, impairing the diagnosis.
“Pediatricians should pay attention to children with shortness of breath and fever, and if diarrhea and / or abdominal pain or cough develop, think about COVID-19. Coughing was rare during hospitalization, but it was a sign of Death warning for Abdominal pain and diarrhea were the most frequent symptoms in children older than one year, ”says Marinho.
Doctors remember that the probability of death in newborns is higher than in children older than one year because their immune system, responsible for the defense of our body, is still “in formation.”
In addition, another cause of infant death in Brazil, which is still being investigated, is the so-called “multisystemic inflammatory syndrome”, which can compromise the brain, causing encephalitis, or important organs such as the heart and kidneys.
In the UK, 1 in 5,000 children who become infected with coronavirus developed this immune system reaction, according to data from the British government.
Symptoms, which include high fever, low blood pressure, and abdominal pain, usually appear about a month after contact with the coronavirus.
The vast majority of children who become infected with the coronavirus do not develop this inflammatory process or recover with treatment. But in some cases, the syndrome can develop into a serious condition and cause death.
It happened with a patient of the pediatrician Jessica Lira, who works in the ICU of the Albert Sabin Children’s Hospital, in Fortaleza, Ceará.
The girl was two years old and developed encephalitis, an inflammation in the brain that appears to have been caused by contamination by the coronavirus.
“He died of brain death. The conversation was difficult, the parents were very angry, they had a hard time understanding how it turned into this. They did not know that covid-19 could lead to a situation like this,” Jessica said. in a recent interview with BBC News Brazil.
Comorbidities and socioeconomic vulnerabilities
But it is the comorbidities and socioeconomic vulnerabilities that have the greatest weight in the death of children from covid-19 in Brazil.
An observational study conducted by Brazilian pediatricians led by Braian Sousa, linked to the Faculty of Medicine of the University of São Paulo (USP), and under the supervision of Alexandre Ferraro, identified comorbidities and socioeconomic vulnerabilities as risk factors for the worst outcome of covid-19 in children.
“Individually, most of the included comorbidities were risk factors. Having more than one comorbidity increased the risk of death by almost tenfold. Compared with white children, indigenous, mixed-race and East Asian children had a significantly higher risk They also found a regional effect (higher mortality in the North) and a socioeconomic effect (higher mortality in children from less socioeconomically developed municipalities) “, say the researchers of the study published on the medrxiv platform.
“In addition to the impact of comorbidities, we identified ethnic, regional and socioeconomic effects that shape the mortality of children hospitalized with covid-19 in Brazil. Combining these findings, we propose that there is a union (interaction between health problems and socioeconomic context ) between covid-19 and non-communicable diseases, driven and fostered by large-scale sociodemographic inequalities. “
“Addressing covid-19 in Brazil must also include addressing these structural problems. Our results also identify risk groups among children that should be prioritized for public health measures, such as vaccination,” the researchers conclude.
A total of 5,857 patients under 20 years of age were studied, all hospitalized with laboratory-confirmed COVID-19.
Similar findings were made by Professor Paulo Ricardo Martins-Filho, from the UFS (Federal University of Sergipe), one of the researchers who publishes the most on covid-19 in Brazil.
He and his team developed a study to estimate the incidence and mortality rates of Covid-19 in Brazilian children and analyze its relationship with socioeconomic inequalities.
And they concluded that there were important regional differences and a relationship between mortality rates and socioeconomic inequalities.
“Knowledge of the sociogeographic differences in the estimates of covid-19 is crucial to plan social strategies and make local decisions to mitigate the effects of the disease in the pediatric population,” says Martins-Filho in the study, published on the scientific platform international PMC.
Therefore, these children end up becoming more vulnerable to diseases, including the coronavirus.
“Of course, the more cases we have and therefore more hospitalizations, the higher the number of deaths in all age groups, including children. But if the pandemic were controlled, this scenario could obviously be minimized,” he says. BBC News Brazil Renato Kfouri, president of the Scientific Department of Immunizations of SBP (Brazilian Society of Pediatrics).
Frontline
“Most of the children who die have comorbidities, especially cancer patients (with cancer) or who are overweight and obese. There are also those who have lung and heart problems. But this is not a rule. We see healthy babies and children dying from covid , something that is not present in the first wave, ”Lohanna Tavares, pediatric infectologist at the Infection Control Commission of the Albert Sabin Children’s Hospital in Fortaleza, Ceará, tells BBC News Brazil.
Pediatricians believe that the death of these healthy children may be related to external factors, such as malnutrition and other diseases, such as dengue, for example, but this correlation has not yet been studied.
Tavares reinforces another factor that has contributed to the increase – and already identified in studies on the subject: lack of assistance.
“Hospital beds and access to pediatric care are much smaller for children than for adults. Several pediatric hospital wards have been replaced by adult beds. Of course, the greatest need is for adults. Restriction of pediatric beds generates an accumulation of patients in emergencies, which makes the pediatrician himself consider more the hospitalization of the child ”, he says.
“That is, it will only enter the most affected children, with a more serious condition, when the ideal would be to leave under observation the cases that can lead to complications. But there are not enough beds. When the number of pediatric beds are reduced, the system is overloaded and assistance suffers ”, he laments.
Currently, there are no vaccines available for children under 16 years of age. “But studies are already being done with this audience,” recalls SBP’s Kfouri.
[ad_2]
